Certified Coder (PRN)

Responsible for daily coding, auditing and diagnosis-related group (DRG) validation of assigned encounters is accurate and compliant with outpatient standards

Responsibilities

• •Conduct reviews and provide recommended corrections of billed services for medical records, ensuring accuracy and compliance with current coding guidelines and regulations
• •Conduct DRG validation to ensure appropriate assignment based on clinical documentation and coding
• •Review and audit billed services, providing recommended corrections related to clinical documentation to maintain coding integrity
• •Assist in reviewing and responding to payer and governmental audits of billed services
• •Stay current with and apply new coding guidelines and codes, maintaining expertise in CPT, HCPCS, and ICD-10 coding systems
• •Meet established daily accuracy and production standards as per department policy
• •Collaborate with healthcare team members to ensure continuity of services and clarity in clinical documentation

Qualifications

Required

• •High school diploma or GED
• •One or more of the following credentials: Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA); or Certified Professional Coder (CPC) and Certified Outpatient Coder (COC) through the American Academy of Professional Coders (AAPC)
• •At least 1 year inpatient medical coding with DRG validation work experience
• •Strong analytical, interpersonal, and communication skills
• •Ability to produce detailed, comprehensive documentation and reports
• •Passing scores on job-related pre-employment assessments

Preferred

Experience in coding or medical billing quality control

Expectations

• •Comfortable with remote work arrangements and virtual collaboration tools
• •Physical demands include extended periods of sitting, computer use, and telephone communication

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Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider.

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